Urgent Care of Vidor

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

L6710 Issued in TX

Legal business name

URGENT CARE OF VIDOR

Practice address

535 N Main St
Vidor, TX 77662-4939

Phone

(409) 783-2525

Fax

(409) 783-2490

NPI assigned

Dec 31, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Phillip Ward, DO

Title

Office Manager

Phone

(409) 783-2525

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1199059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199059200000",
    "number": "1053596791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 N MAIN ST",
            "city": "VIDOR",
            "state": "TX",
            "postal_code": "776624939",
            "telephone_number": "409-783-2525",
            "fax_number": "409-783-2490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 N MAIN ST",
            "city": "VIDOR",
            "state": "TX",
            "postal_code": "776624939",
            "telephone_number": "409-783-2525",
            "fax_number": "409-783-2490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "URGENT CARE OF VIDOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-31",
        "last_updated": "2007-12-31",
        "status": "A",
        "authorized_official_last_name": "WARD",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "409-783-2525",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L6710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Texas Total Care,Inc.
• TMC Provider Group, PLLC
• Triple D Counseling, PLL
• Fre'Daiza La'Shon Tucker
• Tyler County Hospital District
• Vidor Community Health Clinic Inc
• Vidor Dental PLLC
• Vidor Isd
• Vidor Manor Inc
• Vidor Manor Nursing Home Inc

• All providers in Vidor, TX
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.